COGNITIVE FUNCTION, ACTIVITY MEANINGFULNESS, AND SOCIAL ENGAGEMENT AMONG OLDER ADULTS WITH DEMENTIA

Abstract Hess’s selective engagement theory (SET) suggests that individuals facing aging-related decline tend to selectively allocate cognitive resources in activity engagement. This selectivity can be mediated or moderated by motivational factors (e.g., activity meaningfulness). Yet, empirical research on SET and older adults with dementia is limited. This study aims to examine how cognitive function and activity meaningfulness affect social engagement among this population. Data is from the 2016 National Health and Aging Trends Study (N= 1,585 participants aged 65+ with dementia). Engagement in four social activities including visiting family or friends (VF), attending religious activities (RA), participating in group activities (GA), and going out for enjoyment (OE) were analyzed in separate multivariate logistic regression models with cognitive function, the corresponding meaningfulness (a mediator and a moderator), and covariates (age, gender, race, living alone, self-rated health, ADL, IADL, and depressive symptoms). Results showed that, of the four social activities, cognitive function was only significantly associated with RA and GA engagement. RA meaningfulness moderates the association between cognitive function and RA engagement, in that high RA meaningfulness shows high RA engagement, while low RA meaningfulness shows low RA engagement and in a negative association with cognitive function. GA meaningfulness partially mediates the relationship between cognitive function and GA engagement. These findings support SET by showing cognitive resources-related selection effects on activity engagement and the roles of activity meaningfulness in selectivity effects. The implication highlights the importance of sustaining both cognitive function and motivational factors to promote social engagement among older adults with dementia.

preference among people who were growing old?Data from the Taiwan Longitudinal Study on Aging (TLSA) were used to compile an analytic sample aged 50 and older in 1996 with six follow-up interviews to 2019.Four birth cohorts between 1916 and 1953 were identified.The multilevel hierarchical age-period-cohort model (HAPC) were used to examine the effects of age, period, and cohort on potential changes in coresidence preference.Preliminary results suggested that coresidence preference among the post-war birth cohort increased with age, while no clear age patterns were found among other older cohorts.After entering older ages, all birth cohorts converged toward the similar coresidence preference.Findings suggest living with adult children may still be the primary form of living arrangements for older Taiwanese to ensure their sources of care.Despite that realization of coresidence preference would be crucial for older persons' well-being, understanding how coresidence preference changes over time during one's life course can further help us envision the future household structure.Hess's selective engagement theory (SET) suggests that individuals facing aging-related decline tend to selectively allocate cognitive resources in activity engagement.This selectivity can be mediated or moderated by motivational factors (e.g., activity meaningfulness).Yet, empirical research on SET and older adults with dementia is limited.This study aims to examine how cognitive function and activity meaningfulness affect social engagement among this population.Data is from the 2016 National Health and Aging Trends Study (N= 1,585 participants aged 65+ with dementia).Engagement in four social activities including visiting family or friends (VF), attending religious activities (RA), participating in group activities (GA), and going out for enjoyment (OE) were analyzed in separate multivariate logistic regression models with cognitive function, the corresponding meaningfulness (a mediator and a moderator), and covariates (age, gender, race, living alone, self-rated health, ADL, IADL, and depressive symptoms).Results showed that, of the four social activities, cognitive function was only significantly associated with RA and GA engagement.RA meaningfulness moderates the association between cognitive function and RA engagement, in that high RA meaningfulness shows high RA engagement, while low RA meaningfulness shows low RA engagement and in a negative association with cognitive function.GA meaningfulness partially mediates the relationship between cognitive function and GA engagement.These findings support SET by showing cognitive resources-related selection effects on activity engagement and the roles of activity meaningfulness in selectivity effects.The implication highlights the importance of sustaining both cognitive function and motivational factors to promote social engagement among older adults with dementia.

ROLE OF PLACE AS A DETERMINANT OF PARENT-ADULT CHILD GEOGRAPHIC PROXIMITY AND CAREGIVING
Stipica Mudrazija 1 , Elizabeth Peters 2 , and Fernando Hernandez Lepe 2 , 1. University of Washington, Seattle, Washington, United States, 2. Urban Institute, Washington,

District of Columbia, United States
While research has shown that the need for care impacts how close parents and adult children live, the relative importance of various factors shaping parent-child geographic proximity remains unclear, especially as it relates to characteristics of their geographic locations and communities.We explore variation in and determinants of the geographic proximity of older parents and adult children, conditional on parents needing care.Using pooled 2004-2014 data from the Health and Retirement Study on respondents age 65 years or older and their children, alongside detailed county-level contextual information from various sources, we analyze the importance of various determinants of parent-child geographic proximity, including parental health, age, and other personal characteristics, children's personal characteristics, parent-child dyad characteristics, and place-specific characteristics that relate with availability of different health and aging services, housing affordability, and labor market opportunities.Preliminary regression results show that coresidence is substantially less likely in areas with higher availability of nursing care and continuing care options.Among non-coresidents, living in close proximity (distances under 10 miles) is less likely if parent's area has more nursing care options, but more likely if health services that support living in place are available.Additionally, local economic and housing conditions play a role, with higher median household income associated with children living closer to parents and higher cost of rent with living further.Place-specific characteristics are important determinants of parent-child coresidence and proximity, and policymakers and care providers should consider them when determining the most effective ways to support older adults who need care.

TRAJECTORIES OF FORMAL SOCIAL PARTICIPATION, GENDER, AND END-OF-LIFE CARE QUALITY AMONG OLDER AMERICANS
Kafayat Mahmoud 1 , Jarron Saint Onge 2 , and David Ekerdt 2 , 1. Boston University, Boston, Massachusetts, United States, 2. University of Kansas, Lawrence, Kansas, United States Limited research has examined the association between formal social participation trajectories and end-of-life care quality.The end of life could be characterized by experiences of heightened feelings of physical and psychological distress, breathlessness, constant hospitalization, and intrusive interventions.Formal social participation may improve the end-of-life care of older adults because they serve as sources of useful information, receipt of emotional support, and improve self-efficacy.This research examines the associations between formal social participation trajectories and proxy ratings of overall end-of-life care quality, and the moderating role of gender.Growth-based trajectory models were used to identify distinct developmental trajectories of formal social participation among older adults in the United States.Findings revealed four social participation trajectory classes among older adults towards the end of life, all with a general tendency to decline across time.Multinomial logistic regression analyses showed that although older adults with higher levels of formal social participation have more positive overall end-of-life care ratings, there are gender differences in these care ratings.Women are less likely than men to chart, by proxy report, positive care ratings at the end of life even though they have higher levels of formal social participation, and these gender differences in end-of-life care rating are explained more by healthcare factors than formal social participation trajectories.These results suggest that both formal social participation and positive interactions with health care at the end of life are more beneficial for older men than women.

EVIDENCE-BASED STRATEGIES TO DELIVER AND PROMOTE AGE-FRIENDLY CARE IN HOSPITAL SETTINGS
Chair: Barbara King Co-Chair: Mary Hook Discussant: Blair Golden